who decides when i can't?
DESCRIPTION
Information about medical advance directives - Texas specificTRANSCRIPT
Advance DirectivesLaw Offices of Carol Bertsch
1919 San Pedro
San Antonio, Texas 78212-3310
(210) 735-9911 (voice)
(210) 735-1362 (fax)
www.assistingseniors.com
Advance Directives What are they? What do they do? Who needs one?
What are Advance Directives?“Advance Directive” is a general term for any legal document dealing withhealth care decision making, such as a:
Medical Power of Attorney Sometimes called a Health Care Proxy
Directive to Physicians and Family or Surrogates Sometimes called a Living Will
Out-of-Hospital Do Not Resuscitate Order Often referred to as a DNR
HIPAA Authorization
Medical Power of Attorney
Allows you to name person to make health care decisions for you if you can’t (called your “agent”)
Becomes effective only when your doctor says you can’t understand and cannot make decisions for yourself
Unless that happens, no one can make decisions for you.
Directive to Physicians and Family or Surrogates
Allows you to tell the world what kind of care you want if you are terminally ill or in an irreversible condition Terminal - incurable condition that
will produce death within six months, even with life-sustaining treatment
Irreversible - condition that can be treated but never cured; is fatal without life-sustaining treatment
DNR You do not have to be terminally ill
to have a DNR
You must use the state form
A doctor must sign it
HIPAA Authorization
HIPAA stands for the “Health Insurance Portability and Accountability Act”
Allows you to designate others with whom the medical provider may share information about you
Medical providers are sometimes reluctant to disclose information for fear of violating HIPAA
Who Needs Advance Directives?
Everyone
Who Didn’t?
Karen Quinlan Nancy Cruzan Terri Schiavo Hugh Finn
What Happens if You Don’t Have a Medical Power of Attorney?
Consent to Medical Treatment Act Health care provider may look to one
of the following (in order of priority) Spouse Adult child with permission of others Majority of reasonably available adult
children Parents Nearest living relative, member of
clergy
What Happens if You Don’t Have a Directive to Physicians?
Surrogate decision making The health care provider may look
to one of the following (in order of priority)
Spouse Reasonably available adult
children Parents Nearest living relative
What Happens if You Don’t Have a DNR?
In an emergency, if you are unable to make your wishes known, medical personnel must provide whatever treatment is necessary
Revocation
All these documents can be revoked regardless of the maker’s capacity
Preparing Advance Directives
Choosing your agent The best person to select as agent is
someone who:
Is willing to speak out on your behalf if necessary
Is able to act on your wishes and separate his own feelings from yours
Preparing Advance Directives
The best person to select as agent issomeone who:
Could travel to be at your side if needed
Will talk with you now about sensitive issues and will listen to and act on your wishes
Will likely be available long into the future
Preparing Advance Directives
Thinking about treatment…
Are some conditions worse than death?
How do you weigh the odds of survival?
Preparing Advance Directives
Thinking about quality of life…
What’s important, what’s not? Recognizing loved ones?
Communicating with others?
Being pain free?
Preparing Advance Directives
Talking to your agent and family
The more thoroughly you communicate, the easier it will be for everyone to respect your wishes
It will help you think about what you want
It may even bring your family closer together
Now what?
Keep your original advance directives and your notes or worksheets where they can easily be found when needed
Give copies of the directives and your notes or worksheets to your agent
Let your agent know where to find the originals
Give copies of your directives to your doctor. Make sure your doctor will support your wishes
Now what? (cont’d)
Re-examine your advance directives
Before each annual physical exam
At the start of each decade of your life
After any major life change - marriage, divorce, remarriage
After any major medical change
Other Resources
Caringinfo.org
for Advance Directive forms
Texasprobate.com
for Advance Directive forms